Family-System Therapy Theories and Practices An Introduction

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Family-System Therapy Theories and Practices An Introduction Outline

Family Systems Theory & Concepts RBell Spring 2003

Past or Present? An Important Distinction in FT Approaches a Two basic approaches: • Ahistorical – Communication, Strategic, Structural, Contextual, Behavioral • Historical – Object Relations, Multigenerational (Bowenian), Psychoanalysis Some Major Family Therapy Approaches a ———— – Behavioral a Virginia Satir – Communicationa Ivan Boszormenyi-Nagy – Contextuala Salvador Minuchin – Structurala Jay Haley – Strategica David & Jill Scharff – Object Relationsa Murray Bowen – Multigenerational Behavioral Approach Is ahistorical & is concerned with how, when, where, & what rather than why. Reward/punishment norm. Guided by "the basic belief that behavior is determined more by its consequences than by its antecedents." (Dorothy & Raphael Becvar, Family Therapy: A System Integration,2nd ed., Boston: Allyn & Bacon, 1993, 257) Focus is upon having the couple/family members increase the frequency of positive behavior. See Richard Stuart, Helping Couples Change, NY: Guilford, 1980) Communications Approach – Satir a Focuses upon “the redundant patterns of communication and interaction within and between systems.” (Becvar & Becvar, Family Therapy, 211) a Clear, congruent messages are necessary for healthy family relationships. a Incongruent communication styles/stances include: placating, blaming, super-reasonable, & irrelevant or distracting. Contextual Family Therapy – Boszormenyi-Nagy Transgenerational, psychoanalytical approach that focuses upon fairness in family relationships, equitability, trustworthiness, & loyalty. Seeks to uncover & resolve family "obligations" and "debts" incurred over time. Discusses "loyalty" and "legacy;" thrust is to establish or restore trustworthiness in family relationships. Therapist does not take a prescriptive, restructuring role, nor a reframing one; instead, elicits family members’ thinking about the other persons’ perspectives as well as their own. Structural Family Therapy – Minuchin Salvador Minuchin – worked with poverty-stricken, underprivileged families grappling with day-to-day survival (Philadelphia Child Guidance Center). Structuralism refers to the identification of codes that regulate human behavior. Identifies the regulating codes in reference to boundaries, alignment, & power. Uses three "challenging" strategies to address the family’s symptom, structure, & reality. Therapist takes a very active and manipulative role. Strategic or Problem-Solving Family Therapy – Haley Jay Haley – worked with Minuchin from 1967-76. BeganFamily Therapy Institute in Washington, D.C. in 1976. Developed a brief, problem-focused approach. Contends that"change occurs not through insight and understanding butthrough the process of the family carrying out directivesissued by the therapist." (Becvar & Becvar, Family Therapy, 193) Concerned principally with four interrelated elements:symptoms, metaphors, hierarchy, & power. Strong emphasison symptoms which are seen as a way of communicatingmetaphorically within the family. Therapist adopts anauthoritative stance that is highly directive & uses very manipulative procedures. Object Relations Family Therapy – Scharff A psychoanalytic approach that focuses on the family by "listening, responding to unconscious material, interpreting, developing insight, and working in the transference and countertransference toward understanding & growth." "Insight occurs when we can s ee together that the way the family relates to the therapist reflects the transference of repressed feelings and behavior rooted in earlier experiences with the families of origin. The therapeutic relationship offers an environment similar enough to stimu late this emergence but different enough to allow reworking." (David & Jill Scharff, Object Relations Family Therapy, NJ: Jason Aronson, 1987, 3) Bowenian Family Theory Concepts Murray Bowen – clinical work with schizophrenics & theirfamilies at the Menninger Clinic & NIMH. Provides theorybase to bridge psychodynamic and systems approaches. 8 interlocking concepts or forces shaping family functioninginclude: 1) Differentiation of Self2) Triangles3) Nuclear Family Emotional System4) Family Projection Process5) Emotional Cutoff6) Multigenerational Transmission Process 7) Sibling Positions 8) Societal Regression a One’s theory may become a cognitive frame that limits and determines what one can see. a A solution? An integrative, systematic approach to assessment where "one moves through a series of steps in order to arrive at an adequate assessment of the problem. This approach allows for an unfolding of the problem, . . . It begins with the simplest and most obvious level, that of problem-solving, and then moves sequentially through other stages. Assessment at each level ought to lead either to resolution of the problem or to assessment at another level." • David C. Olsen, Integrative Family Therapy (Minneapolis: Fortress, 1993), 39-40. An Integrative Model Problem Solving Structural Issues Interactional Issues Cognitive Issues Family-of-Origin Issues Individual Assessment